(CNN) -- A now-retracted British study that linked autism to childhood vaccines was an "elaborate fraud" that has done long-lasting damage to public health, a leading medical publication reported Wednesday.

An investigation published by the British medical journal BMJ concludes the study's author, Dr. Andrew Wakefield, misrepresented or altered the medical histories of all 12 of the patients whose cases formed the basis of the 1998 study -- and that there was "no doubt" Wakefield was responsible.

"It's one thing to have a bad study, a study full of error, and for the authors then to admit that they made errors," Fiona Godlee, BMJ's editor-in-chief, told CNN. "But in this case, we have a very different picture of what seems to be a deliberate attempt to create an impression that there was a link by falsifying the data."

Britain stripped Wakefield of his medical license in May. "Meanwhile, the damage to public health continues, fueled by unbalanced media reporting and an ineffective response from government, researchers, journals and the medical profession," BMJ states in an editorial accompanying the work.
Explainer: Autism and vaccines

Speaking to CNN's "Anderson Cooper 360," Wakefield said his work has been "grossly distorted" and that he was the target of "a ruthless, pragmatic attempt to crush any attempt to investigate valid vaccine safety concerns."

The now-discredited paper panicked many parents and led to a sharp drop in the number of children getting the vaccine that prevents measles, mumps and rubella. Vaccination rates dropped sharply in Britain after its publication, falling as low as 80% by 2004. Measles cases have gone up sharply in the ensuing years.

In the United States, more cases of measles were reported in 2008 than in any other year since 1997, according to the Centers for Disease Control and Prevention. More than 90% of those infected had not been vaccinated or their vaccination status was unknown, the CDC reported.

"But perhaps as important as the scare's effect on infectious disease is the energy, emotion and money that have been diverted away from efforts to understand the real causes of autism and how to help children and families who live with it," the BMJ editorial states.

Wakefield has been unable to reproduce his results in the face of criticism, and other researchers have been unable to match them. Most of his co-authors withdrew their names from the study in 2004 after learning he had had been paid by a law firm that intended to sue vaccine manufacturers -- a serious conflict of interest he failed to disclose. After years on controversy, the Lancet, the prestigious journal that originally published the research, retracted Wakefield's paper last February.

The series of articles launched Wednesday are investigative journalism, not results of a clinical study. The writer, Brian Deer, said Wakefield "chiseled" the data before him, "falsifying medical histories of children and essentially concocting a picture, which was the picture he was contracted to find by lawyers hoping to sue vaccine manufacturers and to create a vaccine scare."
Unfortunately, (Wakefield's) core group of supporters is not going to let the facts dissuade their beliefs that MMR causes autism.
--Dr. Max Wiznitzer, pediatric neurologist
RELATED TOPICS

* Vaccines
* Autism
* Measles
* Medical Treatments and Procedures

According to BMJ, Wakefield received more than 435,000 pounds ($674,000) from the lawyers. Godlee said the study shows that of the 12 cases Wakefield examined in his paper, five showed developmental problems before receiving the MMR vaccine and three never had autism.

"It's always hard to explain fraud and where it affects people to lie in science," Godlee said. "But it does seem a financial motive was underlying this, both in terms of payments by lawyers and through legal aid grants that he received but also through financial schemes that he hoped would benefit him through diagnostic and other tests for autism and MMR-related issues."

But Wakefield told CNN that claims of a link between the MMR vaccine and autism "came from the parents, not me," and that his paper had "nothing to do with the litigation."

Read autism coverage on "The Chart" blog.

"These children were seen on the basis of their clinical symptoms, for their clinical need, and they were seen by expert clinicians and their disease diagnosed by them, not by me," he said.

Wakefield dismissed Deer as "a hit man who has been brought into take me down" by pharmaceutical interests. Deer has signed a disclosure form stating that he has no financial interest in the business.

Dr. Max Wiznitzer, a pediatric neurologist at Rainbow Babies & Children's Hospital in Cleveland, said the reporting "represents Wakefield as a person where the ends justified the means." But he said the latest news may have little effect on those families who still blame vaccines for their children's conditions.

"Unfortunately, his core group of supporters is not going to let the facts dissuade their beliefs that MMR causes autism," Wiznitzer said. "They need to be open-minded and examine the information as everybody else."

Wakefield's defenders include David Kirby, a journalist who has written extensively on autism. He told CNN that Wakefield not only has denied falsifying data, he has said he had no way to do so.

"I have known him for a number of years. He does not strike me as a charlatan or a liar," Kirby said. If the BMJ allegations are true, then Wakefield "did a terrible thing" -- but he added, "I personally find it hard to believe that he did that."

Hi, the journalist could be right, but then again he could be scapegoating. Its hard to say without good information, which is the point of scapegoating. Even if you are innocent, most will still doubt you, just in case. Bye, Alex

I have absolutely no trust in the medical industry, so I really don't know what to make of this news.

I would love to hear richvank's take on this. Maybe he can make some sense of it...

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I've read a fair amount of pros and cons on this issue, including a length 60-Minutes segment. Here's a current CNN segment. Though I'm no scientist (which might give me higher credentials LOL), I generally side with Wakefield on this one.

I find the arguments against him as weak and inarticulate, while I find Wakefield's replies to be plausible and credible. His critics often come across to me as arrogant, angry and self-righteous. Wakefield comes across to me as quite humble. Just my take.
However, it is hard to believe that a "leading British Medical Journal" could be wrong.

Vaccine developer Paul Offit has just published a new book, Deadly Choices, in which he turns up the volume and the rhetoric against what he likes to call “the anti-vaccine movement.” His target, he argues, has launched a dangerous assault on the public health, and its misguided disciples are everywhere, including people like you and me. Based on the advance description, I don’t plan on boosting his sales.

Yes Wakefield's results were weak and later thoroughly debunked by the Danish study (where they actually compared those who had not received MMR with mercury and had a very large sample size). But that doesn't mean the guy was deliberately committing fraud.

The conflict of interest is a problem - and that was the reason given for the original retraction of the article. But many of the UK psychiatrists publishing GET, CBT articles also have similar conflicts of interest - why aren't those articles being retracted too?

I wonder why BMJ are being so vindictive?
The result sadly is that the exposure might (ironically) lead to more people believing the mercury/MMR-Autism link. But I guess the people at the BMJ are ignorant of such effects.

Yes Wakefield's results were weak and later thoroughly debunked by the Norwegian study (where they actually stopped giving MMR and had a very large sample size). But that doesn't mean the guy was deliberately committing fraud.

The conflict of interest is a problem - and that was the reason given for the original retraction of the article. But many of the UK psychiatrists publishing GET, CBT articles also have similar conflicts of interest - why aren't those articles being retracted too?

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Well yes. By the 'logic' in how Wakefield was treated and his co-authored paper CENSORED, this 'should' be done to probably thousands of papers, particularly the GET/CBT/ psychogenic explanations for CFS, and their authors censured, hauled before the GMC etc. etc.: whether its conflict of interest, weak results hyped up (unwittingly or deliberately?) making 'inappropriate' generalisations to the press etc. etc.

Yes Wakefield's results were weak and later thoroughly debunked by the Norwegian study (where they actually stopped giving MMR and had a very large sample size). But that doesn't mean the guy was deliberately committing fraud.

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Read the whole story. He was committing fraud, actively falsifying medical records and cherry-picking cases to make his fraudulent conclusions.

What Wakefield has done should be beyond horrifying to everyone who believes in good, objective, honest science. As ME/CFS patients, I don't believe we should complain about the effects that bad science has had on the way we've been treated, and then turn around and defend this charlatan, whose fraudulent work has done nothing but mislead the public.

I have absolutely no trust in the medical industry, so I really don't know what to make of this news.

I would love to hear richvank's take on this. Maybe he can make some sense of it...

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Hi, JPV.

I don't have firsthand information about this. I have heard Dr. Wakefield speak at conferences, and I have watched interviews with him. He strikes me as an honest person. He has admitted that he rewarded kids at his son's birthday party for giving blood samples to be used as controls in his research. That may not have been good judgment on his part, but no one has suggested that it did the kids any harm. Before reaching any conclusions about this, I think we should wait to see what Dr. Wakefield has to say.

As far as the vaccine--autism link is concerned, as far as I know there has not yet been a good study of the effect of giving children so many vaccines at the same doctor visit, as is frequently done. I suspect that that could be too large an impact on their undeveloped immune systems. I would like to see such a study done.

It's true that there is a lot of money involved in the vaccine business, and it's true that representatives of vaccine makers sit on the CDC committee that recommends the vaccine schedule for children. This seems to me to have the appearance of a conflict of interest.

Whenever there is a lot of money on one side of an issue, I think we should be aware that the media in the U.S. is supported by advertising money, and it is likely that they will be sympathetic to those who support them financially. If they weren't, they wouldn't be in business very long. Unfortunately, medical journals are also subject to this kind of influence.

I do agree that vaccines are very important from a public health standpoint, but I think that the number of vaccinations should be limited to the ones that are really needed from a health standpoint, apart from the business aspects. I also think that it would be wise to spread them out in time, so that the impact on the immune system would not be as great.

I have heard many parents of autistic children report at conferences that their children were normal until right after they received certain vaccinations. I believe these parents. I think they are in the best position to know about what happened to their children, and I don't believe that they are lying in hopes of collecting some money in a legal settlement.

I don't think that vaccines are responsible for all cases of autism, but I would say that combinations of them should be considered a major suspect for many of them. More careful and honest research needs to be done in this area.

Read the whole story. He was committing fraud, actively falsifying medical records and cherry-picking cases to make his fraudulent conclusions.

What Wakefield has done should be beyond horrifying to everyone who believes in good, objective, honest science. As ME/CFS patients, I don't believe we should complain about the effects that bad science has had on the way we've been treated, and then turn around and defend this charlatan, whose fraudulent work has done nothing but mislead the public.

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Well- I have kept abroad of as much of the 'story' as I can- and I am one of those who don't take any claims at face value. The various allegations made against Wakefield are -mm- problematic, and I for one have never been afraid to question and identify what's 'fact' and what is just ad hominem and appeals to authority (which don't scare me either, I should say).

So I stand by my original statement here.

If we went back to the original article, more of us may be able to make a more informed opinion. Well - wouldya look at that ? They've CENSORED it! (I have actually read the original article, by the way.)

If we went back to the original article, more of us may be able to make a more informed opinion. Well - wouldya look at that ? They've CENSORED it! (I have actually read the original article, by the way.)

The Lancet paper was a case series of 12 child patients; it reported a proposed “new syndrome” of enterocolitis and regressive autism and associated this with MMR as an “apparent precipitating event.” But in fact:

*

Three of nine children reported with regressive autism did not have autism diagnosed at all. Only one child clearly had regressive autism
*

Despite the paper claiming that all 12 children were “previously normal,” five had documented pre-existing developmental concerns
*

Some children were reported to have experienced first behavioural symptoms within days of MMR, but the records documented these as starting some months after vaccination
*

In nine cases, unremarkable colonic histopathology results—noting no or minimal fluctuations in inflammatory cell populations—were changed after a medical school “research review” to “non-specific colitis”
*

The parents of eight children were reported as blaming MMR, but 11 families made this allegation at the hospital. The exclusion of three allegations—all giving times to onset of problems in months—helped to create the appearance of a 14 day temporal link
*

Patients were recruited through anti-MMR campaigners, and the study was commissioned and funded for planned litigation

The worse thing, whether he was right or wrong is, is that it is just about impossible here in the UK for a referral to a GI, who will actively look at the bowels of these children. I only know of one GI in the UK, in London, and he has had to close his books to any fresh cases, as he was inundated when word got round that he would scope, if the symptoms indicated. As a lot of autistic kids cannot tell their parents when they are in pain, the nightmare continues. And guess what, kids who do get scoped and are found to have inflammation have first had to endure the whole shebang of "it's all behavioural" from psychologist's, when their parents have commented on posturing, and other indications of bowel problems. Here is a link to Dr Krigsman, who once worked with Andrew. Some pictures are not for the faint hearted!

Ok- these allegations by Brian Deer are - full of problems. Issues of self-report by parents and instabilities in diagnoses from doctor to doctor would account for any of these APPARENT anomalies (we've only Deer's word for it here that they are actually those), and his way of writing places a certain spin with words like 'allegations' for parental attribution of MMR. And that's just for starters. He makes a lot of assertions that the reader has no way of checking up also. Those points made above (quoted by urbantravels) are not substantiated with first-hand evidence.

If this wasn't a 'trial by Deer and the BMJ' and I was trying to ascertain what was fact and what was semantics and spin, I'd be asking for a lot more evidence than the assertions of this BMJ article.

The original article really needs to be read, for one thing. First hand documentary evidence, re-interviews of parents? Consent for notes?

However, this is not accessible to us. We are supposed to take on trust these vague allegations as 'bogus' and 'elaborate fraud'.

That's pretty damn amazing. There are loads of doctors and researcher out there, who, with the right spin and ad hominem attacks on their intentions, could be dragged through the quagmire and subject to their reputation being trashed in this way.

Ok- these allegations by Brian Deer are - full of problems. Issues of self-report by parents and instabilities in diagnoses from doctor to doctor would account for any of these APPARENT anomalies (we've only Deer's word for it here that they are actually those), and his way of writing places a certain spin with words like 'allegations' for parental attribution of MMR. And that's just for starters. He makes a lot of assertions that the reader has no way of checking up also. Those points made above (quoted by urbantravels) are not substantiated with first-hand evidence.

If this wasn't a 'trial by Deer and the BMJ' and I was trying to ascertain what was fact and what was semantics and spin, I'd be asking for a lot more evidence than the assertions of this BMJ article.

The original article really needs to be read, for one thing. First hand documentary evidence, re-interviews of parents? Consent for notes?

However, this is not accessible to us. We are supposed to take on trust these vague allegations as 'bogus' and 'elaborate fraud'.

That's pretty damn amazing. There are loads of doctors and researcher out there, who, with the right spin and ad hominem attacks on their intentions, could be dragged through the quagmire and subject to their reputation being trashed in this way.

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Yes, I agree. Thanks for putting some analysis into this and not blindly accepting what BMJ and the media has to say. We should be very wary what is going on with autism because we see a lot of the same tactics being used on us. We might learn something from what's going on in the autism community and be better prepared to defend ourselves against the same type of tactics used on them.